Efficacy and safety of daratumumab, pomalidomide, and dexamethasone versus daratumumab, carfilzomib, and dexamethasone in daratumumab-naïve relapsed multiple myeloma

Eur J Haematol. 2024 Jun;112(6):975-983. doi: 10.1111/ejh.14193. Epub 2024 Feb 21.

Abstract

Objectives and methods: We conducted a multicenter retrospective study to analyze the safety and efficacy of DPd versus DKd in daratumumab naïve RRMM patients treated in real-world practice.

Results: A total of 187 patients with RRMM were included in the analysis; 128 patients received DPd, and 59 patients received DKd. A vast majority (80%) of patients had lenalidomide refractory disease and nearly 50% had bortezomib refractory disease. The overall response and complete response rates were 76% and 34% in the DPd group versus 80% and 51% in the DKd group, respectively. With a median follow up of 36 months for the entire patient population, median PFS and OS in the DPd versus DKd groups were 12, 12, 37, and 35 months, respectively. The most common grade 3+ adverse events in the DPd versus DKd groups were neutropenia (32% vs. 7%), anemia (14% vs. 10%), thrombocytopenia (13% vs. 15%), and cardiovascular events (4% vs. 15%), respectively. Both DPd and DKd appeared to be a safe and effective treatment options for RRMM.

Conclusions: While there were more cytopenias associated with DPd and more cardiovascular side effects with DKd, there were no significant differences in the survival outcomes with these two regimens.

Keywords: carfilzomib; daratumamab; multiple myeloma; pomalidomide; refractory; relapsed.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal* / administration & dosage
  • Antibodies, Monoclonal* / adverse effects
  • Antibodies, Monoclonal* / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Dexamethasone* / administration & dosage
  • Dexamethasone* / adverse effects
  • Dexamethasone* / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma* / diagnosis
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / mortality
  • Oligopeptides* / administration & dosage
  • Oligopeptides* / adverse effects
  • Oligopeptides* / therapeutic use
  • Recurrence
  • Retreatment
  • Retrospective Studies
  • Thalidomide* / administration & dosage
  • Thalidomide* / adverse effects
  • Thalidomide* / analogs & derivatives*
  • Thalidomide* / therapeutic use
  • Treatment Outcome

Substances

  • daratumumab
  • pomalidomide
  • Dexamethasone
  • Antibodies, Monoclonal
  • carfilzomib
  • Thalidomide
  • Oligopeptides